Beating COVID-19: What The East Got Right, And West Got Wrong
It's said to be cultural differences, but what separates the success of countries in East Asian and Oceania is above all a question of policy choices.
Last week, with COVID-19 daily case counts hitting new record highs across both the Western Hemisphere and Western Europe, life in the East was remarkably normal. Countries like Taiwan, Japan, South Korea, New Zealand have managed to stave off both major restrictions and to keep the case death toll at a minimum. In China, where the virus first began to spread late last year, there were exactly 738 cases registered throughout the entire month of October, and the economy is back to chugging at full steam.
Many point to the culture in Asian countries as a key to their success against the coronavirus. Because populations tend to be more collectivist and obedient, and some governments are more authoritarian, the reasoning goes, it's easier for Asian countries to adopt the draconian measures required to fight the pandemic. Western individualism, meanwhile, is a disadvantage in times when a united, coordinated response is needed.
But citing culture may hide more than it reveals. New Zealand is an open, liberal country, not a communist dictatorship. Taiwan and Japan, too, are thriving democracies. All three countries fare better than the US and parts of Western Europe in various indicators of a healthy free society, such as the Human Development Index.
No, when it comes to limiting COVID's spread and death count, and preventing the second wave of infections, it is ultimately a question of policy choices made and actions taken. Here's a look at what the East did right, and what the West got wrong:
1. Testing, testing, testing
When China (official caseload since the start of the pandemic: 85,940; deaths: 4,634. Many question the accuracy of Chinese government data) discovered six new cases of Covid-19 and six new asymptomatic cases in the coastal city of Qingdao, it moved to test all of the city's nine million residents — in just five days. It wasn't a first: China had done the same in Wuhan, population 11 million, and has since also mass screened the western city of Kashgar,La Stampareports.
The rate of almost two million tests per day in just one city remains unimaginable in Europe, where countries currently test between 200,000 and 400,000 people per day.
European countries had been warned. Just one of many examples: in August, a prominent Italian microbiologist, Andrea Crisanti, had recommended the government quadruple the country's testing capacity, as he explained in Milan dailyCorriere della Sera. What happened to the plan? "It was ignored by the government," Crisanti said recently.
At the current rate of testing, it would take health authorities 34 days to test the entire city of Milan, population 1.4 million — and only if they chose to stop testing all other towns in the surrounding region of Lombardy.
Be smart: By itself, building capacity wouldn't have prevented the second wave. Testing campaigns must be strategic and data-driven, although it's difficult to do that now that France is recording close to 50,000 new cases per day. "You have to test with a purpose," French epidemiologist Dominique Costagliola toldLe Monde.
But Asian countries have been doing this since day one. In South Korea (caseload: 26,271 total cases; 462 deaths), health workers have been using phone location data to identify thousands of people potentially at risk. In Vietnam (caseload: 1,177 total cases; 35 deaths), authorities have focused on high-risk individuals and on buildings and neighbourhoods where there have been confirmed cases.
2. Act quickly
When Italy announced a ban on gatherings, shut nightspots and high schools earlier in October, not many knew it was copying South Korea, one of the democratic countries most often praised for its effective containment policies.
The difference? On the day South Korean health minister Park Neung-hoo announced the restrictions in late August, saying his people were in "a very dangerous situation", South Korea reported 332 new cases.
On 24 October, when Italy closed cinemas, theatres and gyms and mandated high schools to continue remotely for 75% of classes, the country had 19,644 cases and 151 deaths per day — by then, it was too little, too late.
In France, introducing measures earlier would have made it "possible to break the dynamic, with less strong measures than those announced today," said Costagliola. "The longer we delay, the more the pandemic progresses, the more we are in this phase of rapid growth, requiring to act strongly."
A medical worker demonstrates collecting sample for the COVID-19 PCR test in Kashima, Japan — Photo: AFLO/ZUMA
3. Total eradication v. flattening the curve
When to end restrictions is as important as when to introduce them. When the West introduced the first nationwide lockdowns in the spring, scientists, politicians and the media told the public that the restrictions were necessary to "flatten the curve". The more we practice social distancing, the rationale was, the slower the virus will spread and kill, the more manageable the health crisis will be.
But countries that have succeeded in staving off a second wave of infections have worked to extinguish the virus altogether, not just flatten the curve.
New Zealand (1,949 total cases, 25 deaths), for example, introduced a national lockdown on March 25, when it recorded 102 cases and 0 deaths.
When the lockdown was lifted on June 8, the country had had no new local transmission in 17 days, and all patients had fully recovered. To date, life in New Zealand is almost entirely back to normal, with some social distancing.
4. Tighter borders
Countries such as Italy, Greece, Spain and France, whose economies rely on tourism, rallied to reopen borders and allow international visitors to spend the summer holidays there.
But the most successful countries have reopened their borders cautiously, if at all.
Experts point to Taiwan's (553 total cases, 7 deaths) border restrictions as among the most efficient: until the end of June, all new arrivals — tourists, business travelers as well as residents — had to book themselves into a hotel to self-quarantine for two weeks.
The government subsidised the stay, including a welcome package with dish soap, nail clippers and laundry detergent to facilitate the quarantine; food was delivered on their doorstep; a local district office would phone at least once a day to check in and thank them for doing their part.
In European countries, closing schools and working from home during the second wave seemed like an unspeakable taboo: the countries just couldn't afford to close down again. All levels of government opposed new closures, even when their countries recorded more than 20,000 new cases every day.
Asian countries such as China and South Korea, instead, have acted decisively at the local level whenever they saw new flare ups. When Beijing recorded 31 new coronavirus cases on June 10, they shut down schools and urged people to work from home. Offices and schools reopened shortly after.